An Unexpected Consequence of Experiencing Sexual Assault? High Blood Pressure

Sexual assault and sexual harassment have been linked to a slew of mental health issues for survivors, but a new study suggests that both can cause a serious physical issue: high blood pressure.

The study, published in the Journal of the American Heart Association, analyzed data from 33,127 participants in the Nurses' Health Study II, a long-term health study that analyzes the impact of nutrition, lifestyle, and environmental factors on the health of nurses. The researchers specifically focused on women who didn't have high blood pressure at the start of the study. During a follow-up interview, some reported experiencing sexual assault or workplace sexual harassment.

During the follow-up period, 7,096 women developed high blood pressure (aka hypertension), with those who had faced sexual harassment or assault being at a higher risk. Researchers specifically found that 23 percent of those who developed high blood pressure had been victims of sexual assault, while 12 percent had faced workplace sexual harassment—and 6 percent of those who developed high blood pressure experienced both.

Compared to women who didn't report being sexually assaulted or harassed, women who went through both had a 21 percent increased risk of high blood pressure. There was a 15 percent higher risk in women who experienced workplace sexual harassment and an 11 percent higher risk in women who were sexually assaulted.

Almost 43 percent of women in the U.S. aged 20 and up have high blood pressure, which is defined as 130/80 mm Hg or higher, according to the American Heart Association (AHA). High blood pressure has been linked to many serious health conditions, including stroke, heart attack, heart failure, and kidney disease.

“People tend to separate mental health from physical, but they're very interconnected.” —Andrea Roberts, PhD

"Given the burden of sexual assault and workplace sexual harassment against women, we felt it was a priority to better examine a potential relationship between these types of sexual violence and the risk of hypertension," says lead study author Rebecca Lawn, PhD, a postdoctoral research fellow at the Harvard T.H. Chan School of Public Health. "As cardiovascular disease is the leading cause of death of women worldwide, we believe that understanding the relationship between sexual violence and cardiovascular disease risk factors, such as hypertension, is critical."

The study's findings are scary, and they also raise a huge question: Why? A few potential factors are at play, says study co-author Andrea Roberts, PhD, senior research scientist at the Harvard T.H. Chan School of Public Health. One is that going through a sexual assault or sexual harassment increases stress, and "stress can directly affect your blood pressure," she says.

"It is also possible that stress affects behaviors, such as smoking, which could also lead to an increased risk of hypertension," Dr. Lawn says. Stress can also increase the risk of stress eating, which can contribute to an increase in blood pressure, Roberts says.

Trauma expert Luana Marques, PhD, associate professor in the Department of Psychiatry at Harvard Medical School and a clinical psychologist at Massachusetts General Hospital agrees that unhealthy coping mechanisms—along with the burden of living with chronic stress—may be at play. "Individuals who have experienced sexual assault/harassment may attempt to cope with the emotional sequelae of the event by engaging in activities that increase hypertension," she says. Dr. Marques lists things like having a glass of wine and binge-watching shows. "In other words, they try to cope by avoiding feelings or thoughts related to the event," she says. "These behaviors can help individuals feel momentarily better, but over time may result in lifestyle changes that can increase risk for hypertension."

"People tend to separate mental health from physical, but they're very interconnected," Dr. Roberts says.

If you've been the victim of sexual assault or harassment, Dr. Marques recommends doing what you can to bring your "heightened physiological response down." That can include taking stock of how you think about yourself, how that makes you feel, and what you do as a result. She also suggests allowing yourself to feel intense emotions related to your experience. "Do your best to say with those emotions rather than avoiding them," Dr. Marques says. "Your brain and body can only maintain a heightened sense of arousal for a limited period and, over time, you will begin to feel better."

Finally, Dr. Marques suggests being more active by taking time for daily physical activities. "It's common for individuals who have experienced trauma or stress to feel tired or restless," she says. "Keep your 'batteries' charged—and reduce the risk of hypertension—by taking time to move each day."

And, if you feel comfortable, Dr. Lawn also suggests sharing with your healthcare provider that you've been a victim of sexual violence so that they can keep closer tabs on your physical health.

If you do develop hypertension after sexual assault or workplace harassment, Dr. Roberts points out that lifestyle modifications and medications can help bring it back down. However, she stresses, "our emphasis and desire is really to limit those exposures to sexual violence in the first place."

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